Porter J D
Department of Clinical Sciences, London School of Hygiene and Tropical Medicine, UK.
J Antimicrob Chemother. 1996 May;37 Suppl B:113-20. doi: 10.1093/jac/37.suppl_b.113.
Human immunodeficiency virus (HIV) infection alters the epidemiology of mycobacterial infections. In the industrialised world, this has led to an increase in severe illness associated with Mycobacterium avium-intracellulare complex (MAC) and, in the developing world, to doubling of tuberculosis cases in some countries in Sub-Saharan Africa. The interaction with Mycobacterium tuberculosis occurs when the CD4 count is relatively high (> 200) and tuberculosis (TB) is now the commonest presenting AIDS defining disease in Africa. In international public health terms the interaction between TB and HIV infection has led to the World Health Organisation declaring TB to be a global emergency. Both TB and HIV are diseases of poverty and the key to the reduction of incidence of both diseases is the improvement of socio-economic conditions. Other control methods are case finding and treatment, chemoprophylaxis and BCG vaccination. Finding active (sputum positive) case of tuberculosis and treating them is the function of TB control programmes in all countries, but poor adherence to medication has lead to low cure rates and increasing development of drug resistance. Resources are needed to improve adherence to medication and for research to improve diagnostic methods and treatment.
人类免疫缺陷病毒（HIV）感染改变了分枝杆菌感染的流行病学特征。在工业化国家，这导致了与鸟分枝杆菌胞内复合体（MAC）相关的严重疾病增多；在发展中国家，撒哈拉以南非洲的一些国家结核病病例数翻了一番。当CD4细胞计数相对较高（>200）时，会发生与结核分枝杆菌的相互作用，而结核病现在是非洲最常见的界定艾滋病的疾病。从国际公共卫生角度来看，结核病与HIV感染之间的相互作用已导致世界卫生组织宣布结核病为全球紧急情况。结核病和HIV都是贫困相关疾病，降低这两种疾病发病率的关键在于改善社会经济状况。其他控制方法包括病例发现与治疗、化学预防和卡介苗接种。发现活动性（痰涂片阳性）结核病病例并进行治疗是所有国家结核病控制项目的职能，但药物依从性差导致治愈率低且耐药性不断增加。需要资源来提高药物依从性以及开展研究以改进诊断方法和治疗。
